The relationship between suicide and self-injury is complicated. While people with non-suicidal self injury do not intend to completed suicide, they may cause more harm than intended, which could result in medical complications or death. In severe or prolonged cases of self-injury, a person may become desperate about their lack of control over the behavior and its addictive nature, which may lead them to true suicide attempts.
If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted. An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing. Self-injury treatment options include outpatient therapy, partial-inpatient hours a day and inpatient hospitalization.
When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended. For example, you may want to tell: a friend or family member, your GP, someone on an emotional support line, where you can remain anonymous if you prefer. What do I tell them? When do I say it? Where do I tell them?
Why am I telling them? You might tell them because: you want to share that you self-harm or why you do it, you might feel that you have given them the wrong impression about how you feel or why you self-harm, or you want support to stop self-harming.
What do I do if they struggle to understand? The two main ways recommended by NICE to manage self-harm are: Short term management of self-harm, and Long term management of self-harm.
There is no safe way to self-poison. Your GP should still monitor your physical health. Long-term management of self-harm If you need long-term management for your self-harm, your GP may offer you an assessment with your local community mental health team CMHT.
This should contain information such as: how to stop your self-harm from getting worse, how to reduce or stop harm caused by your-self harm, how to lessen risky behaviours, how to improve your ability to function, and how to improve your quality of life.
Your care plan should also: identify goals that you would like to achieve in life, such as employment goals, identify team members and what they should be doing for you, include a risk management plan, identify short term goals linked to your-self harm, and be shared with your GP. It should look at: current risk, long term risk, things that increase your risk of self-harm, and a crisis plan.
You may be offered: cognitive behavioural therapy, psychodynamic therapy, or problem solving therapy. Your therapist should help you understand the reasons why you self-harm. Ending care with the specialist mental health team When your treatment and care is due to end professionals should: tell you what is likely to happen when your care ends tell you ahead of time so that you can get used to the change give you extra support if you need it, make sure you have a clear crisis plan in place, share your care plan with any other professionals who are taking over your care, give you a copy of your plan and what has been agreed, and give your family or carer a copy of the plan if you agree You can find more information: Talking Therapies by clicking here.
Care Programme Approach by clicking here. Medication — choice and managing problems by clicking here. What if I am not happy with my treatment? There is more information about these options below. Treatment options You should first speak to your doctor about your treatment. Second opinion A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. Advocacy Advocates help you to deal with and overcome issues that you have.
These are available in all areas. Community or mental health advocates can support you to get a health professional to listen to your concerns. These are available in some areas only. You can find out more about: Second opinions by clicking here.
Advocacy by clicking here. Complaints about the NHS or social services by clicking here. Going to hospital What will happen if I need to go to hospital?
The assessment is to understand your: physical risk of harm, your mental state, your mental capacity, your willingness to stay in hospital for further assessments, your distress level, and any possible mental health issues Everyone who self-harms should: have treatment for serious injuries, have a risk assessment, and be offered a needs assessment.
Have you been drinking or taking illegal drugs? Why did you self-harm? Do you have a history of self-harm? Do you have a mental health condition? Do you have mental capacity? Do you have a plan to kill yourself? Are you feeling hopeless or depressed? You may have a risk assessment and needs assessment at the same time. You can leave if you want to unless: Professionals have assessed you and think you lack capacity to make that decision. Or, You are detained under the Mental Health Act.
You can find more information about: The Mental Health Act by clicking here. Mental capacity and mental illness by clicking here. Stay in hospital. You may be kept in hospital overnight. You may be kept in hospital if you were going to go back to an unsafe place. This may be because you were too distressed or under the influence of alcohol or drugs. An assessment of your needs should be done with you as soon as possible. You may be referred for further assessment and treatment.
This will be a joint decision between you and health care professionals. The decision to refer you should be based on the assessment of your needs and risk.
You may be discharged without a follow up appointment. This decision will be based on your needs assessment and risk. The assessment should be written in your medical notes and passed to your GP and any other relevant mental health services. Helping myself How can I help myself? Delay self-harm You may self-harm straight away when you are distressed. Non-harmful ways to manage how I feel Talk to someone who understands. If you feel that you have to self-harm, try the following instead: Write down how you are feeling and then tear it up or rip it up.
Punch a punch bag or kick something soft. Scream into a pillow. Go for a walk. Play a sport, exercise or go to the gym. Bite into a piece of ginger or a chilli. Squeeze an ice cube as hard as you can. Snap elastic bands on your wrist. Form an image of yourself feeling empowered. For example, try imagining yourself as superhero.
Or try to remember a time you felt strong and positive about yourself. If you are feeling low or anxious you could try the following. Pamper yourself. Have a bath with bath oil. Do something active.
Clean up or clear out your wardrobe. Choose a random object and think of 10 different uses for it. Before harming, write down the answers to these questions.
Why do I feel I need to hurt myself? What has happened to make me feel like this? How do I feel right now?
Have I been here before? What did I do to deal with it? How did I feel then? What have I done to make myself feel better before?
What else can I do that won't hurt me? Do I need to hurt myself? How will I feel when I am hurting myself? How will I feel after hurting myself? How will I feel tomorrow morning? Can I avoid what has made me feel like this, or deal with it better in the future? Make sure anything you cut yourself with is clean.
For example, use new blades. Think carefully about where you cut. Avoid areas such as the insides of the wrists or the tops of the legs, as it can be risky to cut here. Make sure you are up to date with your tetanus jab. Tetanus is a serious infection. Scar tissue may not be as strong as your skin. Think about cutting down on or avoiding drugs or alcohol.
They can affect your judgement. Learn first aid and keep first aid supplies nearby. Such as antiseptic wipes and bandages. Have an emergency plan, such as keeping a phone nearby so that you can ring an ambulance if you need to. Set yourself limits before you self-harm and stick to them. Such as decide how many cuts you will make and how big they will be.
This is a good way of learning the skills you need to stop. Try other techniques such as snapping elastic bands on your wrist. If you self-harm by hitting yourself, put towels, or something else around your fists to soften the blow. Think of other options instead of swallowing medication or substances. See the previous section for ideas. How can I deal with my scars? How can I deal with questions about my scars?
You could think about what you want to say if someone asks you. How can I reduce my scars? Long sleeved tops and trousers can hide scars. However, not everyone who self-harms wants to end their life. Some people describe their self-harm as a way of staying alive by responding to or coping with severe emotional distress.
It's important to find the right support or treatment to help deal with the underlying cause in a less harmful way. This video explores why young people may self-harm and gives advice on how to get the right support.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Nonsuicidal self-injury, often simply called self-injury, is the act of deliberately harming your own body, such as cutting or burning yourself. Share on: Facebook Twitter. Show references Russell KR, et al.
Identifying the signs of self-harm in students. Rochester, Minn. National Alliance on Mental Illness. Accessed Oct. Edmondson AJ, et al.
Non-suicidal reasons for self-harm: A systematic review of self-reported accounts. Journal of Affective Disorders. Butler JA. Self-directed violence and other forms of self-injury.
Centers for Disease Control and Prevention.
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